Y
yolipatty
Guest
What is the name of your state?
I'm in Queens, New York.
I have insurance through my company. I have a PPO. My husband was diagnosed w/bladder cancer. The Dr. we chose, we found out after the first consulation, that he was not part of the network. I paid the consultation on my own. The Dr. assured me that he applied to be part of my ins. network, but he was not approved yet. He also told me that he will send a letter requesting this approval early so he can operate on my husband. I made numerous calls to the ins co. to verify if this letter was received. My last conversation w/the ins co they told me that he was approved and he can operate within network. (I made sure I asked this more than once).
To my surprise, I received my insurance co. Explation of Benefits in which they only pay 60% because I chose a Dr. not in network. When I called the first time, to ask about this, I was told that my Dr. was in network, but not in my area. After discussing this with doctors office I was assured by his secretary the doctor was in network and was approved by the ins co. In my subsequent inquire, (the second time) I was told the my doctor was not in network. As you can see, the insurance company gave me different information. Today, I received another Explanation of Benefits indicating the hospital was not in network either. In total I owe over $7,000.
The company claims that the approval was for the doctor to operate as an out-of-network doctor. I do not need approval from my insurance co. to seek an out of network doctor.
Please help. We went ahead with this doctor because we were assured by insurance co and doctor that this would be a full covered operation.
Any help would be greatly appreciated
I'm in Queens, New York.
I have insurance through my company. I have a PPO. My husband was diagnosed w/bladder cancer. The Dr. we chose, we found out after the first consulation, that he was not part of the network. I paid the consultation on my own. The Dr. assured me that he applied to be part of my ins. network, but he was not approved yet. He also told me that he will send a letter requesting this approval early so he can operate on my husband. I made numerous calls to the ins co. to verify if this letter was received. My last conversation w/the ins co they told me that he was approved and he can operate within network. (I made sure I asked this more than once).
To my surprise, I received my insurance co. Explation of Benefits in which they only pay 60% because I chose a Dr. not in network. When I called the first time, to ask about this, I was told that my Dr. was in network, but not in my area. After discussing this with doctors office I was assured by his secretary the doctor was in network and was approved by the ins co. In my subsequent inquire, (the second time) I was told the my doctor was not in network. As you can see, the insurance company gave me different information. Today, I received another Explanation of Benefits indicating the hospital was not in network either. In total I owe over $7,000.
The company claims that the approval was for the doctor to operate as an out-of-network doctor. I do not need approval from my insurance co. to seek an out of network doctor.
Please help. We went ahead with this doctor because we were assured by insurance co and doctor that this would be a full covered operation.
Any help would be greatly appreciated